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I'm applying for SSI -But my case is "complicated"-Advice?-Have fibromyalgia w/ sleep complications

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Boxerfan Donating Member (710 posts) Send PM | Profile | Ignore Thu Mar-24-11 12:50 PM
Original message
I'm applying for SSI -But my case is "complicated"-Advice?-Have fibromyalgia w/ sleep complications
I applied last year & was denied.

My old doctor had run every test in the book trying to diagnose me for muscle pain & extreme fatigue.

I have an obvious sleep condition due to failed saliva glands after a tumor was removed. This requires me to wake 20+ times a night to sip soda water & quench my mouth.Also being a older male I have prostate issues so peeing is also something I have issues with.

I also have a torn tendon that was repaired but still keeps me from doing any heavy arm work(rt arm & I'm right handed). I now get a small disability check from a workmens comp claim-but that runs out in a few months. I have a host of issues -hemmerhoids & back spasm due to pinched nerve wich are miserable but not a constant.

My main issue is fatigue-in the last 4 years it has become severe to the point I had to stay in bed for a week at a time. It still happens but if I can excercise I do & that helps.

I have to dose myself with caffiene to be functional at all in the AM. I have good days & bad days but I can not schedule them.

I also have been self medicating for my entire adult life with pot. Luckily I qualify for it but that does not protect me from pee testing.

I went to have my BP medicine refilled. My old Dr. had moved & the new Dr. actually had reviewed my charts(wowza!). He asked if I knew about fibromyalgia & gave me some info. Upon reading the info-I realized this is what I was dealing with. I could have written the pamplet.

So on my 2nd visit he gave me a diagnosis that I did indeed suffer from the condition.

Problem is-He won't say I'm unable to work. Its a gray area he says.

I am able to function some mornings & definitely for no more than 4 hours. But I can't tell wich days-Also muscle pain & sometimes inflamed bowels keep me from doing anything even if I am "awake".

My energy is a well so to speak. I can dip deeper at times but I will pay hell for it later.

Then there is the fact I need my medicine to survive at any functionality-and employers don't like my choice of medicine.


Thanks for reading this far & what are my chances?. I hate to loose part of my claim to a lawyer-but if thats the only way I can get my coverage-so be it.

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LaurenG Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 12:56 PM
Response to Original message
1. I am not certain of this but I think you should apply for SSDI
instead of just SSI. Also be prepared to have to apply an average of 3 times unless of course you have an atty. Best wishes to you.
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happyslug Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Apr-02-11 01:27 PM
Response to Reply #1
13. When you apply for SSDI you also apply for SSI
The definition of disability for SSI is a reference to SSDI. Thus if you are disabled for one program, you re applying for both.
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SheilaT Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 12:57 PM
Response to Original message
2. I was a paralegal for about six months to an attorney
who did Social Security Disability appeals cases. She took on those who'd already been turned down, but she only took on those she felt should clearly win.

Now, I am not an attorney myself, and nothing I say can be construed as legal advice, but I can tell you what I learned. First of all, you need EXTENSIVE documentation about your condition and your inability to work. Reams and reams of medical records. And if your own doctor isn't willing to certify that you are unable to work, it's a problem. Perhaps you need another doctor, one who will understand the exact nature of your problem and be willing to certify that you can, in fact, not hold down a job.

From attending a couple of hearings, I know that the government standard is that you cannot work at least part time in some area you are reasonably well qualified to do. At these hearings there was also someone who was some kind of expert in the thousands of employment classifications, and I was surprised in both directions what was considered "able to work".

Attorneys who take on these cases work on a contingency basis, and the fees are strictly set by the government. The good news is that if you win your appeal, you get retroactive payment.

So, look on the internet or in the phone book to see if there are any such attorneys in your area. I will tell you this, that if you talk to two or three of them and they don't want to take on your case, you really are not a candidate for disability.
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catbyte Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 12:58 PM
Response to Original message
3. My only advice is keep at it & don't give up
My husband applied for SSD in 2001 and it took almost 5 years for him to be approved. At the time, he'd had Type I Diabetes for 43 years and severely injured both shoulders in a mishap at work. We finally had to hire a lawyer and it still took 3 years and 1/3 of his retroactive award. I think their strategy is to just wear you down to point that you either give up or die--at least that's how it was during the Dark Times, aka BushCo.

Don't give up! :hi:

Anishnabe in MI
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mysuzuki2 Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 01:11 PM
Response to Original message
4. I am a recently retired Social Security employee
with 30 years experience. First of all, don't hire an attorney at this point. If your claim is denied, file an appeal. If and when your case goes in front of an administrative law judge, then you want a lawyer. DO NOT hire some out of state mega-law firm you see advertising on cable tv. They'll just take your $$. Most areas have lawyers who specialize in social security law. Also, there are legal aid groups that sometimes can help. The fact that your Dr won't say that you can't work is unimportant. When you go to the dr. make sure it gets in his notes how all of this is affecting what you are able to do. What is important to SS is whether your medical issues restrict your activities to the point that you can't do substantial work. Example; it is not important whether you have a sleep problem or fibromyalgia. It is instead important how these conditions limit your activities (can't stay awake during the day, need frequent breaks, etc). When filling out your paperwork, stress these things. I wouldn't mention the MJ if I were you-it's largely irrelevant but it might prejudice your case with some people. A question-how old a guy are you? If over 62 you can get reduced retirement benefits while waiting for a disability decision. The most important advice I can give you is to apply-you can do it online but it goes quicker if you call 1 800 772 1213 and make an appt for a phone interview-they can fill out the papers a lot quicker than you can. If you have to appeal, do it right away. There are time limits and it takes long enough anyway. Get started and good luck!
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Boxerfan Donating Member (710 posts) Send PM | Profile | Ignore Thu Mar-24-11 01:28 PM
Response to Reply #4
8. Thanks-I have a scheduled interview in a few weeks...
Trying to get my ducks in a row.

I'll try & find some local advice.

I'm only 53 so no reduced benefits available.

My condition has been well documented-blood workups & sugar testing etc..-all trying to find the reason for my fatigue & pain. If my old Dr. had not quit I still wouldn't know what was really wrong.

Hopefully I can get a second opinion from a Dr more versed in the condition. But affording it is a major issue.

Lots of good advice-Thanks
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happyslug Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Apr-02-11 01:58 PM
Response to Reply #8
15. Age 50 and 55 are major ages for SS.
Edited on Sat Apr-02-11 02:03 PM by happyslug
At age 50, if a person is disabled and can not return to pass work, then SS will only consider Light, Sedentary, medium Work (Sedentary work is NOT considered after age 50, unless you did that type of work before you applied for SS).

Here is a paper I posted on DU in 2003, Goes into details on how SS makes its decision:
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happyslug Donating Member (1000+ posts) Send PM | Profile | Ignore Sat Apr-02-11 01:55 PM
Response to Reply #4
14. I do SS work, and I concur, not much I can do till the ALJ hearing
The real test is can you do work related activities? Generally if your Doctor can show you will be off task 10% of each hour (I.e. about six minutes, Not including regular work breaks), miss more then one day a month of work., have to walk away from the job every 15 or 20 minutes, or have to lay down every 30-45 minutes (People have had these restrictions in cases I won).

Now, cases an issue like yours, where people are off task and has medical evidence to support that restriction (NOT proof that you have those restrictions, but evidence that support that you can have that restriction), almost always go to an ALJ Hearing. The main reason for this is that at the ALJ hearing a Vocational Expert (VE) will be in the hearing who will testify that if someone is off task 6 minutes an hour, lay down every 30-45 minutes, have to walk away from a work site every 15 minutes, or miss more then one day a month do to illness, is unemployable for entry level jobs (Higher end jobs permit more time being off work, so the above goes for most jobs).
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KT2000 Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 01:17 PM
Response to Original message
5. My only advice
is to be very careful when selecting other doctors to give you documentation. Get involved with fibromyalgia groups, locally or on the internet, and get doctor recommendations from them.

There are doctors who either do not believe that fibromyalgia exists or they are priming their practice to make more money supplying documentation against claims. There is a lot of money involved in doing that and bright futures for them too. They get referrals from governments and companies that do not want to pay claims.

What you do not want is documentation from one of those doctors because they would hold great weight as one you selected and then you would have to argue against them.

You will probably be turned down once, twice etc. so you have to keep working at it.

Good luck to you.
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Boxerfan Donating Member (710 posts) Send PM | Profile | Ignore Thu Mar-24-11 01:19 PM
Response to Original message
6. Yes-SSDI...Thanks for the replies
And I hope it does go through...Guess I do need a lawyers opinion. As far as getting 2nd opinions-I'm lucky to have any coverage at all. I am on my wifes policy & she has been cut back to 10 hours a week this month. We barely pay for the premium. But she can't quit or we would loose that & she is an "older" worker so...No real chance of getting another job nowadays.

The odds of me finding an employer who can work with my disability are zip zilch nada.

And I don't think I can outlast the system financially...

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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 01:27 PM
Response to Reply #6
7. SSDI attorneys work on pure contingency, and the amount
of their fees is strictly limited by law. Start calling attorneys who specialize in that area of law in your area and get consultations. They're very picky about which clients they take, since they won't be compensated if they don't win, so you may have to try more than one.

The Social Security Administration turns down approximately 75% of initial claims. They do it almost as a matter of fact. SSDI attorneys can usually win if they think your case has merit. They're good at what they do, and when they win, you get retroactive payment from your first filing date.

Make some calls and get help. It'll cost you nothing unless you succeed. Seriously. Why wouldn't you?
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CountAllVotes Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 03:27 PM
Response to Reply #7
9. excellent advice
Edited on Thu Mar-24-11 03:27 PM by CountAllVotes


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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 06:44 PM
Response to Reply #9
12. I wrote the content for a website for an SSDI attorney last year,
and got all the skinny on it in the process.
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Boxerfan Donating Member (710 posts) Send PM | Profile | Ignore Thu Mar-24-11 03:47 PM
Response to Reply #7
10. Found one in my area that handles fibromyalgia cases..Made an apt..
So got the ball rolling.

I know y'all know but...

DU rocks..I got some solid advice here very quickly.
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MineralMan Donating Member (1000+ posts) Send PM | Profile | Ignore Thu Mar-24-11 06:43 PM
Response to Reply #10
11. Good luck with that. I hope it works out for you.
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tryingtobehopeful Donating Member (5 posts) Send PM | Profile | Ignore Sun May-01-11 05:07 PM
Response to Reply #11
16. i am having problems with it too
i have a bad CME report from SSA's psychologist on my first case, which was denied all the way through appeals, and i don't have the money nor energy to appeal it. the terrible lawyer doesn't appeal to the federal level anyway, so i am free of them, thank God.

i just sent the reconsideration request for my second claim. i have an appt. with a local lawyer who was recommended to me AFTER all of the above happened on the first claim. i hope the local lawyer takes my case, since local lawyers usually know the judges involved.

what makes me mad is that the CME report from the first claim is still on my second claim. and i feel like that is tainting my claim, and any future ones i may have to file. is there a way to erase that CME, since it is three years old now? my condition has worsened, and i have my own psuchiatrist and therapist who i have been seeing for almost three years now. i really want that old cme removed from my record. the guy is a jerk.
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